Individual
MS. JASMINE ANNGENIKA FAMBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LLMSW
Contact information
Practice address
43740 N GROESBECK HWY, CLINTON TOWNSHIP, MI 48036-1139
(586) 469-7629
(586) 466-4143
Mailing address
43740 N GROESBECK HWY, CLINTON TOWNSHIP, MI 48036-1139
(586) 469-7629
(586) 466-4143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
104100000X
Social Worker
Primary
6801097829
MI
106S00000X
Behavior Technician
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
11/15/2012
Last updated
05/02/2018
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